Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | M1994 | TX |
NPI | 1083615223 |
---|---|
Provider Name | Dr. Donald O Ozumba |
First Address | Dallas, TX 75204-1401 |
Second Address | Dallas, TX 75204-6613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 03/05/2012 |